Racial/Ethnic Disparities in the Identification of Children With Autism Spectrum Disorders

By D. Mandell, L. Wiggins, L. Carpenter, J. Daniels, C. DiGuiseppi, M. Durkin, E. Giarelli, M. Morrier, Joyce S. Nicholas, J. Pinto-Martin and 4 more. American Journal of Public Health, 2008

786 citations recorded by the source corpus.

Objectives We sought to examine racial and ethnic disparities in the recognition of autism spectrum disorders (ASDs). Methods Within a multisite network, 2568 children aged 8 years were identified as meeting surveillance criteria for ASD through abstraction of evaluation records from multiple sources. Through logistic regression with random effects for site, we estimated the association between race/ethnicity and documented ASD, adjusting for gender, IQ, birthweight, and maternal education. Results Fifty-eight percent of children had a documented autism spectrum disorder. In adjusted analyses, children who were Black (odds ratio [OR] = 0.79; 95% confidence interval [CI] = 0.64, 0.96), Hispanic (OR = 0.76; CI = 0.56, 0.99), or of other race/ethnicity (OR = 0.65; CI = 0.43, 0.97) were less likely than were White children to have a documented ASD. This disparity persisted for Black children, regardless of IQ, and was concentrated for children of other ethnicities when IQ was lower than 70. Conclusions Significant racial/ethnic dispatrities exist in the recognition of ASD. For some children in some racial/ethnic groups, the presence of intellectual disability may affect professionals’ further assessment of developmental delay. Our findings suggest the need for continued professional education related to the heterogeneity of the presentation of ASD.

Subfields: Clinical Psychology, Cognitive Neuroscience, Occupational Therapy

View Paper: https://www.semanticscholar.org/paper/59cba7f725dca5ce2740257c42e605de326368e3

How researchers see this paper

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In Clinical Psychology

1. E. Hoff
2. K. Diamond
3. Deborah L. Schussler
4. Meredith Rowe
5. I. Schwartz

In Cognitive Neuroscience

1. S. Goldin‐Meadow
2. Deborah L. Schussler
3. Paul L. Morgan
4. Meredith Rowe
5. Susan C. Levine
6. George Farkas
7. I. Schwartz
8. E. Hoff

In Occupational Therapy

1. Deborah L. Schussler

Citations in the corpus

• Are Black Children Disproportionately Overrepresented in Special Education? A Best-Evidence Synthesis (2017, background): “e979) racial and ethnic disparities in health and health care, including Black children being less likely to be diagnosed and treated for autism spectrum disorder, attention deficit hyperactivity disorder, and other conditions (Mandell et al., 2009; P. L. Morgan et al., 2015; Pastor & Reuben, 2005).”
• Language intervention research in early childhood care and education: A systematic survey of the literature (2020, background): “This may be due to the fact that children from racial/ethnic nd linguistically diverse backgrounds are less likely to receive an SD diagnosis, compared to children from majority groups (e.g., andell et al., 2009).”
• Race, Culture, and Autism Spectrum Disorder: Understanding the Role of Diversity in Successful Educational Interventions (2009, background): “Mandell et al. (2009), who calculated ORs for the presence of documented autism in 8-year-old minority children through the CDC’s ADDM network, also found underidentification of autism in African American children (OR = 0.79) and Hispanic children (OR = 0.76; they did not calculate separate ORs for…”